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Pancreas transplantation with grafts from donors deceased after circulatory death (DCD): 5 years single center experience

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Abstract

Introduction

Donation after circulatory death (DCD) pancreas transplantation has been shown to be an additional way to deal with donor organ shortages. The results of 5-year DCD pancreas transplantation are presented.

Methods

A retrospective, single center analysis (2011 – 2015) was performed to compare the results of donation after brain death (DBD) to DCD pancreas transplantation.

Results

During the study period, 104 pancreas transplantations (83 from DBD and 21 from DCD) were performed. Median pancreas donor risk index (PDRI) was 1.47, (DBD 1.61 vs. DCD 1.35 (p=0.144)). Without the factor DCD, PDRI from DCD donors was significantly lower (DBD 1.61 vs DCD 0.97 (p<0.001). Donor age was the only donor related risk factor associated with pancreas graft survival (HR 1.06, p=0.037). Postoperative bleeding and kidney DGF occurred more frequently in recipients from DCD (p=0.006). However, DCD pancreata had a lower incidence of thrombosis. Kidney and pancreas graft survival were equally good in both groups.

Conclusions

Pancreas transplantation from DCD donors yields comparable results to DBD donors when PDRI of DCD are relatively low. Most DCD donors are younger donors with trauma as cause of death. These DCD pancreas grafts may be a better option to cope with increasing organ shortages than exploring the limits with older (and higher PDRI) DBD donors.

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